How long does Strattera work for?
ByAs one of the newest medicines out for ADHD, there is the shortest long term track record for Strattera, compared to the other medications.
One question which people often ask is: “How long the benefits of Strattera last for?”
Although Strattera is not addictive at all, people also ask: “Will the benefits wear off, or will tolerance develop (i.e. will the dose have to be increased over time)?”
A recent study was published which addressed this issue. It was published in the Journal of Pediatrics (a great and respected Journal), and one of the authors was the researcher from Harvard – Dr. Timothy Wilens.
This study was a ‘meta analysis’, which means that it pooled the data from 13 individual studies. This is a common technique to gather more data than any one study can gather.
This study followed teens taking strattera for over two years. What was found was that the strattera started working in the first three months of treatment, and the benefit carried on for the full two years of the study. The teens did not require dose increases to maintain the benefit of the medication.
Of the initial 601 teens (12-18 years old) who started on Strattera, 219 completed a full two years of treatment in the study. While this may not look like a high percentage, it is actually a great number, as following up in a study requires a big time commitment and adherence to a protocol, which can get taxing over two years.
During the 2-year period, 99 subjects (16.5 percent) stopped taking Strattera due to lack of effectiveness and 31 (5.2 percent) discontinued treatment due to side effects. The most common side effects were: nausea, stomach aches and head aches. Importantly, there were no changes in height or weight over the two year study. Remember, this study did include 12 year olds, so they are in the age of significant growth.
The bottom line: for a relatively new medicine, this is a good study to show that this medication works well over time, and does not lose its effectiveness without dose increases (in general). There were no surprises with side effects, and the reasons for stopping treatment.
To read a full report of the study, click here.
Thank you for the informative blog on strattera. My son will be visiting his doctor again on Aug 25th and she wants to put him on this medication. I was and still is a little weary about medication seeing he is just 7 yrs old. There is a long story behind my son and his actions and I won’t get into it here, but his doctor seems to think he is ADD. Can it really be diagnosed that fast. She has only seen him once before. Are there more things I should be taking into consideration before I actually put him on the medication if he really needs to be on it. Confused and need more answers.
Lori,
Thanks for your comments.
The important issue here is to ask many questions, get educated, and to make informed decisions.
This blog will contain enough information for you to be able to fully understand the diagnosis, treatment decision making, medication issues, etc. Just give me a little time
Take the time to learn what you need to learn.
When I work with patients, I often think about treating ADHD as a marathon – not a sprint. In other words, you’re in it for the long haul, so unless there are crisis issues, take some time to ensure you really understand what is going on.
Thanks for the information, Dr. Handelman.
I have a question: You note in your article that “there were no changes in height or weight over the two year study.” Are you saying that there was no loss in the growth *curve* these kids were on, or that the children didn’t grow or gain weight over the two years of the study? The latter would be quite alarming.
One of the concerns we have about usage of Strattera on our son, who’s been taking it a little over two years, is that he seems to have grown very little the past two years. He dropped from 90th percentile to 75th between his 9-year and 10-year well-checks, and I’m dreading where he will land at his 11-year in a couple of months.
In our case, the drug doesn’t seem to work as well as it did when he first started on it, and his pediatrician feels it is very ineffective for most kids. He suggested a trial of Concerta, which I was trying to avoid because of a family history of bipolar disease and suicide, but we gave it a try. My son had a terrible reaction to it (extreme moodiness and blurred vision), so we discontinued it immediately and he remains on the Strattera.
Not sure if it’s having anything more than a placebo effect at this point (and not much of one at that), but he is extremely spacy and it really bothers him. No hyperactivity whatsoever. I’m not convinced his “ADD” is the primary problem, but his pediatrician feels it is. My son is also extremely bright and is very moody. I’d appreciate any thoughts you have.
Many thanks.
Hi Pat,
Thanks for the comment.
The point that was made regarding the height and weight is the first of your comments – that there was no drop off from the expected gains.
If your son is dropping off from 90th to 75th percentiles, then certainly the doctor should be watching.
I do find Strattera works very well for many patients – but it doesn’t have that clear ‘on and off’ feeling that stimulants do. It may be a dosing issue if the benefits have seemed to wear off over time.
Regarding moodiness, and a family history of bipolar disease – of course that needs watching. A great site for pediatric bipolar is: http://www.bpkids.org
Has your son had psychological testing? Sometimes educational testing with personality/emotional testing as well can reveal very helpful information if you have a question regarding diagnosis. Also, learning disabilities are very common.
Thanks so much for your quick reply!
Yes, my son had testing in second grade (8 yrs. old) by a school psychologist. She found him to be highly gifted but with some type of “processing” disorder. Again, his pediatrician was skeptical. Does he have a hard time retrieving information, which slows him down, or is he distracted due to ADHD? Who knows? And can a symptom of depression be attention problems?
My younger son (who was adopted at five years from Russia) is now seeing a very fine psychiatrist and she is gong to recommend a psychologist for my older son.
Thanks so much.
Whats your take on adults?
Hi Hector,
That is a broad question. Since it is on a post for Strattera – my take is that Strattera can work very well for adults with ADHD. It doesn’t work for everyone, but it can be very helpful.
Let me know if you were asking a different question.
All the best,
Dr. Kenny
My son just recently was prescribed Stattera for ADHD. How long should we expect him to have the nausea? Would it be best if he took the medicine at bedtime rather than in the morning? He is 7 yrs old.
Dr. Handelman,thank you for the information on this site. My son now 27 was percribed Stattera(was diagnosed with ADD) a yr or so ago and had been taking it along with a mood stabalizer called Triliprol. i could seem to notice a difference in his mood and also thinking. but as he always has, stoped taking his meds. Needless to say his mood swinges and thinking has gotten really bad lately he has just decided to try ( and hopefully follows through) with starting both meds again my questions are to you .do you think both theses meds togeather are a good combonation? the doc. that gave him Triliptrol was a different doc than the one that diagnosed him with ADD and gave him the Stattera said it would work togeather ok.does it matter what time of day to take these ? should they be takin at different times? he wants to try to get on a med call Addaral i think to boost his energy level i was wondering if Strattera does this? he has been so weak and sleeps alot! i mean days at a time. i might mention he was addicted to meth at one time but am sure he has been off of it . i saw what he was like for 2 yrs of meth use and saw the signs lingering around as well but have not seen any signs in him or around to make me think he is using drugs he has been tring to get his life togeather and has a child on the way so is really tring for his girlfriends and the babys sake. please any advise you can give me on this situation would be greatly appreciated Mark
DO SOME OF THE SIDE EFFECTS SUBSIDE AND HOW LONG BEFORE THEY DO>
Hi Sue,
Yes, some of the side effects can subside – like nausea or fatigue. How long? if they are still a significant issue after a couple of weeks, they may continue…
Ask your doctor about specifics.
My boyfriend just got on strattera yesterday and he has been sleeping since about 6pm yesterday
I was just wondering how long he should be asleep for.
Kayla – I’m not clear how long he’s been sleeping. Sleepiness is a side effect of Strattera. And sometimes it is worse in the beginning when someone starts the medicine, and gets better day by day.
If you are concerned with the amount of sleep – call the prescribing doctor.
Hello Dr. Handelman,
I have two sons recently diagnosed with ADD. My older son is 20. He was diagnosed with Tourrettes Syndrome at age 9 with possible ADD at that time. As Ritalin and other amphetamines prescribed at that time were proported to exacerbate ticks, as parents, we chose not to medicate, but, to monitor.
The medication recently recommended for my older son is Strattera as he has co-existing social anxiety along with the Tourrettes. The ticks are mild and intermittent, so, they have not been a major concern. The attending psychiatrist has noted exacerbation of ticks when the other amphetamines are prescribed to his patients. Strattera, we are told, has a positive effect on anxiety.
This psychiatrist is thinking our son might have had mild episodes of depression. From parental observations our son does have low self esteem, but, he is generally an optomistic personality. He has always slept poorly and low energy levels are routine. Would Strattera contribute to low energy?
As his medicine options are limited, we have researched and had consultations and examinations with a registered psychologist who uses neurocognitive skill enhancement and neurobiofeedback (with EEG assessment) via software. My own research of the literature including a recent metanalysis conducted by a psychologist out of Dukes University in North Carolina indicates good potential use of this non-medicinal therapy (over 50% success rate). We are thinking of trying this route initially before resorting to drug therapy as there is encouraging data and potential for permanent changes due to the neuroplasticity of the brain. One of our concerns is the time element, as it is suggested the program would be approximately 6 months to get my sons up to speed with their non-ADD cohorts if successful. That being said, the psychologist is very optomistic with respect to the older son.
Your comments would be welcomed.
Many Thanks,
Sue
NB. This is my very first contribution to a blog!
Sue, thanks for joining the conversation. Here are a few thoughts:
Strattera may be a good option – and could work to help the ADHD and not worsen the tics
Wellbutrin is an antidepressant which also has some ADHD properties – it may be an option
Even with tics, stimulants don’t always make them a big problem. You may consider trying it.
Neurofeedback has decent research behind it (it isn’t perfect, but neither is any treatment). The biggest side effect is the time you have to put into it. Review these options with your son, and let him decide what’s best (hopefully with lots of your input!).